the 100% directionless thread

[NysEms2117]

An Associate's Degree will be helpful but won't give you as complete an education as a Bachelors in Kines will do. Most of the nursing prereqs will be prereqs for a Kines Bachelor's program.

I think my nursing endeavor has swayed me from getting a 3rd B.S tbch. I was looking to take 1-2 classes and get an associates.. I mean i get up at 5 and usually go until 7-8 currently anyway, so working out for me won't be a problem i don't think. Thank you for your input and expertise. Would anything such as a CSCS help me to a point for return on investment, i get that more degrees = better on paper? Or any of the "side degrees"? I've been working out(properly) for over 10 years. Back in the glory days was a collegiate athlete ect. And believe it or not, i can play nice with others lol. Part of this that sparked me is i just recently talked to one of my old athletic trainers in college who has the EMS equivalent of alphabet soup (MS,ATC, CSCS, facial stretch, the whole kit and kaboodle) and she rejuvenated my interest clearly not as a full time job tho. I also want to work a lot while im young to get it over with

 

[VentMonkey]

Do you do scene calls and the nurse does IFT?

Yes, we've been on an IFT streak lately as well; it's been nice. The previous rotation seemed exclusively mine. This is most favorable (to the one without charting duties) at 2 a.m.

 

[RocketMedic]

I miss IFTs lol. At least, the complicated ones. I am not the dialysis-transfer or wait-and-return guy. But sick/injured from A to B? That can be fun.

All in all though, I prefer 911. Johnnie and Roy were paramedics, not transporters.

 

[VentMonkey]

I miss IFTs lol. At least, the complicated ones.

Hence the "it's been nice" remark.

Johnnie and Roy were paramedics, not transporters.

While I certainly can't argue that our generations paramedics were founded on Johnnie & Roy, they define the antiquated paramedic, and medicine to match. I strive to remove myself as faraway from this archaic style of paramedicine as possible.

 

[RocketMedic]

Eh, I'd actively avoid that comparison, Vent. There's a lot to like about the culture of service they model. Sure, they call for orders for everything, but so do all of the nurses, all the time. It's just how medicine in the 1970s was, and there's still some salient points there. Personally, I like consultations on things that are odd like yesterday's sick dialysis guy (goes to the ED in Conroe once a week because Davita and Fresinius are trying to kill and harvest DNA for cloning) and I shamelessly asked for advice about his 'low' BP because my physical findings were (better) than the vital signs would indicate.

I don't like systems where nurses are superior to paramedics; I prefer a relatively egalitarian relationship.

 

[VentMonkey]

Well then that is where we differ. I have no issues with any of my above statements. Their "model" of customer service isn't the issue.
Their lack of critical thinking skills is, '70's or not.

When you still practice this style of medicine (and they do) well into the 21st century...yes, I stand by what I say. You yourself, admitted to not knowing the ins and outs of CA EMS, so this statement below holds no validity:

I don't like systems where nurses are superior to paramedics; I prefer a relatively egalitarian relationship.

It's hardly an anti-egalitarian culture where I am, to include my full time assignment. We each have designated roles making one invalid without the other. If anything it creates more cohesion than not. We have so much to learn from on another's practice.

You make mention of the Johnnie & Roy style of patient care, but I ask this? How closely did they lean on, and learn from Dixie McCall?

As far as knowing when to hold'em v. fold'em: I couldn't agree more. There's nothing worse than an egocentric paramedic rush to judgment regardless of the system umbrella they are under, cheers.

 

[RocketMedic]

Well then that is where we differ. I have no issues with any of my above statements. Their "model" of customer service isn't the issue.
Their lack of critical thinking skills is, '70's or not.

When you still practice this style of medicine (and they do) well into the 21st century...yes, I stand by what I say. You yourself, admitted to not knowing the ins and outs of CA EMS, so this statement below holds no validity:

It's hardly an anti-egalitarian culture where I am, to include my full time assignment. We each have designated roles making one invalid without the other. If anything it creates more cohesion than not. We have so much to learn from on another's practice.

You make mention of the Johnnie & Roy style of patient care, but I ask this? How closely did they lean on, and learn from Dixie McCall?

As far as knowing when to hold'em v. fold'em: I couldn't agree more. There's nothing worse than an egocentric paramedic rush to judgment regardless of the system umbrella they are under, cheers.

It's an inherently anti-egalitarian culture when you have to ask a nurse for permission to give more than 100mcg of fentanyl because someone believes there's danger there. It's an inherently anti-egalitarian culture when a simple vent call or a drip requires an RN. It's an inherently anti-egalitarian culture when 1975's "the private ambulance driver shouldn't speak" is still actively sustained. You and your RN partner work well together and learn, great. You're in a rotary-winged CCT environment where that makes sense no matter which state you're in, and for taking complex CCT patients, I think that having complimentary educations and skillsets is a good thing. But for the vast majority of ground EMS, to include ALS transfers, the CA model is really, really regressive.

EDIT: Plus Dixie would be dead in Episode 1 if it wasn't for disregard for orders....

EDIT 2: Plus we don't have a whole boatload of super-elitist Fire ALS here.

 

[VentMonkey]

It's an inherently anti-egalitarian culture when you have to ask a nurse for permission to give more than 100mcg of fentany because someone believes there's danger there.

Rocket, you don't know what you don't know. This is not the case where I am, nor how I practice. Nurse or not, pain management starts all adults at 100 mcg.

It's an inherently anti-egalitarian culture when a simple vent call or a drip requires an RN. But for the vast majority of ground EMS, to include ALS transfers, the CA model is really, really regressive.

This is correct, and with that I will agree.

It's an inherently anti-egalitarian culture when 1975's "the private ambulance driver shouldn't speak" is still actively sustained.

Again, a misconception perhaps you've either come to conclude, or are going off of word-of-mouth.

Having spent a good half of a decade alongside these "fabulous folks" I very much spoke what I felt needed speaking of, or for.
This train-of-thought EMT is often the same ones who want nothing more than to be in their (fire's) shoes, and therefore live in fear of their applications being pushed back because of it.

I met some good people, and made some friends along the way, all while being kicked out of cities, taking them for joyrides, and earning their respect whether they liked it or not. I'll say it again- I learned a lot...indirectly.

I surely did not fit in all too well there in the long run, and ultimately left because of it, but assuming every EMT abides by this mantra is just not accurate.

The ones that I know that are still down there fighting that fight because they have, or had, no other out or option have my respect.

 

[RocketMedic]

I was pointing more at CCEMSA and Riverside County's protocols on PPP than Kern, y'all are considerable bit less bad. You really should introduce Ketamine there though.

 

[RocketMedic]

Side note: learning a lot and memories are not necessarily a substitute for systemic failures. Those happen in any environment. It's fixing the environment that yields real improvements. Kind of like how great soldiers came out of the Vietnam-era Army but the Vietnam-era Army was terrible at fighting well, and the lessons learned made the Army way better.

 

[VentMonkey]

Side note: learning a lot and memories are not necessarily a substitute for systemic failures.

Kind of like how great soldiers came out of the Vietnam-era Army but the Vietnam-era Army was terrible at fighting well, and the lessons learned made the Army way better.

These sound a lot like one in the same. "Learning a lot" in any environment can make an army, or even an individual that much more of a force to be reckoned with.

Having gained wisdom and strength from past mistakes whether they're your own, or your systems will enhance anyone who sees fit to grow from such endeavors. Memories are just fun.

Some of us are not built to change an entire system. Others who are in that position realize just how steep that uphill battle is, and ongoing as well. We can wax poetic about systems and their many imperfections til the cows come home, but the harsh reality is none will ever be perfect unless the individual provider feels said system to be so.

Sometimes accepting what is makes changing what can be that much easier.

 

[RocketMedic]

I think you missed the point.

Plenty of great providers at all levels come out of LA County, and some stay there. Some fight the good fight to change it; some just fight their battles well, and some accept the suck and proceed with grace. That doesn't change that it's the EMS equivalent of the 1965 Vietnam War Army, and burns far more money, resources and provider lives (in terms of professional lifespan, lifestyle and morale) than it needs to. It's a very heavy lift to change that system because the people that enjoy good lifestyles and morale in that system have almost all of the power, very little incentive to change it and a strong respect for traditions that benefit them.

The fact that a lot of great people are there and come from there doesn't change the fact that they're pretty crappy as a whole for the resources that they have, as measured by the "do you want to be sick or hurt here?" criteria.

 

[VentMonkey]

@RocketMedic I did not miss the point, hence my remark:

Sometimes accepting what is makes changing what can be that much easier.

Some battles will never be won in my lifetime, so for me life is too short to be enamored with such fairytales. If I truly want or wish to retire as a ground paramedic I undoubtedly will move out of California. Again, because of my quoted remark.

I think we're comparing apples and pears here- somewhat different, but equally enjoyable.

 

[RocketMedic]

I'll probably retire as an educator, because I don't really have a love for fighting fire or 24/48s and I like teaching, but I really like being a paramedic too, and after seeing Eaglemed 5 in OKC, I have no intention of flying anything that's not .mil or Sikorsky or a fixed-wing flight. That puts me squarely into ground 911 operations, and I have fun with those.

 

[RocketMedic]

Sixteen page paper about the effects of Andrew Jackson's veto of the Maysville Road Act completed. US History is nearly done. Degree #3 is nearly done.

 

[NysEms2117]

Sixteen page paper about the effects of Andrew Jackson's veto of the Maysville Road Act completed. US History is nearly done. Degree #3 is nearly done.

beat me my man, I'm camping at 2 and thinking thats where i shall stay. maybe someday when i'm old and feeble get a masters, but thats not here yet.

 

[cruiseforever]

I have an interview on Monday for a medic job, with a rural hospital based service. It's been over 25 years since I have interviewd for a job. It should be intresting. The main reason that I am even considering it, is because the area is now home.

 

[RocketMedic]

So...Stash Invest is pretty cool. I've been tossing in $5 a week to their "defending America" mutual fund and it's broken $100 in about 15 weeks with a few bucks of return. Going to increase the weekly auto-stash to $15 ( $60/month ) and put it in a moderate risk fund, see what happens. Investing for snowflakes like me allows me to find funds that support things I believe in and that are likely to be profitable.

In other news, my one share of Raytheon is making bank. Bought it in 2009 and have not been disappointed.

 

[EpiEMS]

Kind of like how great soldiers came out of the Vietnam-era Army but the Vietnam-era Army was terrible at fighting well, and the lessons learned made the Army way better.

Have you read "Dereliction of Duty" by HR McMaster?

Btw...what are your degrees in?

So...Stash Invest is pretty cool. I've been tossing in $5 a week to their "defending America" mutual fund and it's broken $100 in about 15 weeks with a few bucks of return. Going to increase the weekly auto-stash to $15 ( $60/month ) and put it in a moderate risk fund, see what happens. Investing for snowflakes like me allows me to find funds that support things I believe in and that are likely to be profitable.

In other news, my one share of Raytheon is making bank. Bought it in 2009 and have not been disappointed.

Pretty cool fin-tech concept, I like these auto-investing solutions.

 

[RocketMedic]

B.S in adult education with emphasis in workforce development (basically, how to teach adults adult things) from the University of Central Oklahoma.
Bachelor's in "Applied Technology" in healthcare management and administration from Brazosport College.
AAS-Paramedic from Rose State College in Oklahoma.

Starting a master's in healthcare administration at the University of Houston this fall.

Haven't read "Dereliction of Duty" yet.